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Published in: Lasers in Medical Science 6/2021

01-08-2021 | Diode Laser | Original Article

Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser

Authors: Sunakshi Soi, Vivek Kumar Bains, Ruchi Srivastava, Rohit Madan

Published in: Lasers in Medical Science | Issue 6/2021

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Abstract

Background

Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient’s overall clinical diabetic management.

Objective

To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis.

Materials and methodology

After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-μm fiber optic delivery system.

Results

Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05).

Conclusion

Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.
Literature
1.
go back to reference Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodntol 6(1):99–112CrossRef Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodntol 6(1):99–112CrossRef
2.
go back to reference Koçak E, Sağlam M, Kayış SA, Dündar N, Kebapçılar L, Bruno G et al (2016) Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial. Lasers Med Sci 31:343–353CrossRef Koçak E, Sağlam M, Kayış SA, Dündar N, Kebapçılar L, Bruno G et al (2016) Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial. Lasers Med Sci 31:343–353CrossRef
3.
go back to reference Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Grazziani F et al (2017) Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol 00:1–12 Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Grazziani F et al (2017) Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol 00:1–12
4.
go back to reference American Diabetes Association (2018) Introduction: standards of medical care in diabetes. Diabetes Care 41(1):S1–S2 American Diabetes Association (2018) Introduction: standards of medical care in diabetes. Diabetes Care 41(1):S1–S2
5.
go back to reference Taylor GW, Borgnakke WS (2008) Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 14:191–203CrossRef Taylor GW, Borgnakke WS (2008) Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 14:191–203CrossRef
6.
go back to reference Awartini FA (2009) Evaluation of the relationship between type 2 diabetes and periodontal disease. Saudi Med J 30:902–906 Awartini FA (2009) Evaluation of the relationship between type 2 diabetes and periodontal disease. Saudi Med J 30:902–906
7.
go back to reference Obradovic R, Kesic L, Mihailovic D, Jovanovic G, Antic S, Brkic Z (2012) Low-level laser therapy as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther 14:799–803CrossRef Obradovic R, Kesic L, Mihailovic D, Jovanovic G, Antic S, Brkic Z (2012) Low-level laser therapy as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther 14:799–803CrossRef
8.
go back to reference Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z (2017) Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 32:449–459CrossRef Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z (2017) Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 32:449–459CrossRef
9.
go back to reference Barbosa FI, Araújo PV, Machado LJC, Magalhães CS, Guimarães MMM, Moreira AN (2018) Effect of photodynamic therapy as an adjuvant to non-surgical periodontal therapy: periodontal and metabolic evaluation in patients with type 2 diabetes mellitus. Photodiagn Photodyn Ther 22:245–250CrossRef Barbosa FI, Araújo PV, Machado LJC, Magalhães CS, Guimarães MMM, Moreira AN (2018) Effect of photodynamic therapy as an adjuvant to non-surgical periodontal therapy: periodontal and metabolic evaluation in patients with type 2 diabetes mellitus. Photodiagn Photodyn Ther 22:245–250CrossRef
10.
go back to reference Castro dos Santos NC, Andere NMRB, Araujo CF, de Marco AC, dos Santos LM, Jardini MAN et al (2016) Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial. Lasers Med Sci 31:1633–1640CrossRef Castro dos Santos NC, Andere NMRB, Araujo CF, de Marco AC, dos Santos LM, Jardini MAN et al (2016) Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial. Lasers Med Sci 31:1633–1640CrossRef
11.
go back to reference Bunjaku V, Popovska M, Grcev A, Mrasori S, Kameri A, Sllamniku Z et al (2017) Non-surgical periodontal treatment and low level laser therapy (LLLT) outcomes for patients suffering from type 2 diabetes mellitus, obesity and chronic periodontitis. J Int Dent Med Res 10:214–221 Bunjaku V, Popovska M, Grcev A, Mrasori S, Kameri A, Sllamniku Z et al (2017) Non-surgical periodontal treatment and low level laser therapy (LLLT) outcomes for patients suffering from type 2 diabetes mellitus, obesity and chronic periodontitis. J Int Dent Med Res 10:214–221
12.
go back to reference Aoki A, Miyuki K, Sasaki, Watanabe H, Ishikawa I (2004) Lasers in nonsurgical periodontal therapy. Periodontol 36:59–97CrossRef Aoki A, Miyuki K, Sasaki, Watanabe H, Ishikawa I (2004) Lasers in nonsurgical periodontal therapy. Periodontol 36:59–97CrossRef
13.
go back to reference Sgolastra F, Severino M, Gatto R, Monaco A (2013) Effectiveness of diode laser as adjunctive therapy to scaling root planning in the treatment of chronic periodontitis: a meta-analysis. Lasers Med Sci 28:1393–1402CrossRef Sgolastra F, Severino M, Gatto R, Monaco A (2013) Effectiveness of diode laser as adjunctive therapy to scaling root planning in the treatment of chronic periodontitis: a meta-analysis. Lasers Med Sci 28:1393–1402CrossRef
14.
go back to reference Chandra S, Shashikumar P (2019) Diode laser - a novel therapeutic approach in the treatment of chronic periodontitis in type 2 diabetes mellitus patients: a prospective randomized controlled clinical trial. J Lasers Med Sci 10:56–63CrossRef Chandra S, Shashikumar P (2019) Diode laser - a novel therapeutic approach in the treatment of chronic periodontitis in type 2 diabetes mellitus patients: a prospective randomized controlled clinical trial. J Lasers Med Sci 10:56–63CrossRef
15.
go back to reference Saglam M, Kantarci A, Dundar N, Hakki SS (2014) Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial. Lasers Med Sci 29:37–46CrossRef Saglam M, Kantarci A, Dundar N, Hakki SS (2014) Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial. Lasers Med Sci 29:37–46CrossRef
16.
go back to reference Crispino A, Figliuzzi MM, Iovane C, Giudice TD, Lomanno S, Pacifico D et al (2015) Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention. Ann Stomatol VI:15–20 Crispino A, Figliuzzi MM, Iovane C, Giudice TD, Lomanno S, Pacifico D et al (2015) Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention. Ann Stomatol VI:15–20
17.
go back to reference Paul P, Bilichodmath S, Sameera U (2018) Clinical and glycemic level evaluation of the efficacy of diode laser and antibiotics with scaling and root planing in treating chronic periodontitis patients with diabetes. J Dent Lasers 12:24–30CrossRef Paul P, Bilichodmath S, Sameera U (2018) Clinical and glycemic level evaluation of the efficacy of diode laser and antibiotics with scaling and root planing in treating chronic periodontitis patients with diabetes. J Dent Lasers 12:24–30CrossRef
18.
go back to reference Cao R, Li Q, Wu Q, Yao M, Chen Y, Zhou H (2019) Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis. BMC Oral Health 19:176CrossRef Cao R, Li Q, Wu Q, Yao M, Chen Y, Zhou H (2019) Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis. BMC Oral Health 19:176CrossRef
19.
go back to reference Löe H, Silness J (1963) Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 21:533–551CrossRef Löe H, Silness J (1963) Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 21:533–551CrossRef
20.
go back to reference Silness J, Löe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135CrossRef Silness J, Löe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135CrossRef
21.
go back to reference Mohan M, Jhingran R, Bains VK, Gupta V, Madan R, Rizvi I et al (2014) Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus. J Periodontal Implant Sci 44:158–168CrossRef Mohan M, Jhingran R, Bains VK, Gupta V, Madan R, Rizvi I et al (2014) Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus. J Periodontal Implant Sci 44:158–168CrossRef
22.
go back to reference Qadri T, Javed F, Johannsen G, Gustaffson A (2015) Role of diode lasers (800–980Nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review. Photomed Laser Surg 33:568–575CrossRef Qadri T, Javed F, Johannsen G, Gustaffson A (2015) Role of diode lasers (800–980Nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review. Photomed Laser Surg 33:568–575CrossRef
23.
go back to reference Convissar RA (2016) Principles and practice of laser dentistry, 2nd edn. Elsevier, New York Convissar RA (2016) Principles and practice of laser dentistry, 2nd edn. Elsevier, New York
24.
go back to reference Kocak E, Sağlam M, Arslan U et al (2020) Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci 35:1403–1410CrossRef Kocak E, Sağlam M, Arslan U et al (2020) Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci 35:1403–1410CrossRef
25.
go back to reference Le R, Zhe Z, Daxu L, Chunni D, Hong T (2018) Clinical efficacy of semiconductor laser-assisted minocycline in moderate-to-severe chronic periodontitis patients with type 2 diabetes mellitus. Trop J Pharm Res 17:1165–1170CrossRef Le R, Zhe Z, Daxu L, Chunni D, Hong T (2018) Clinical efficacy of semiconductor laser-assisted minocycline in moderate-to-severe chronic periodontitis patients with type 2 diabetes mellitus. Trop J Pharm Res 17:1165–1170CrossRef
26.
go back to reference Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA (2005) Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 84:1154–1159CrossRef Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA (2005) Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 84:1154–1159CrossRef
27.
go back to reference Takeda M, Ojima M, Yoshioka H, Inaba H, Kogo M, Shizukuishi S et al (2006) Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. J Periodontol 77:15–20CrossRef Takeda M, Ojima M, Yoshioka H, Inaba H, Kogo M, Shizukuishi S et al (2006) Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. J Periodontol 77:15–20CrossRef
28.
go back to reference Lalla E, Lamster IB, Stern DM, Schmidt AM (2001) Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetics: mechanisms and insights into therapeutic modalities. Ann Periodontol 6:113–118CrossRef Lalla E, Lamster IB, Stern DM, Schmidt AM (2001) Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetics: mechanisms and insights into therapeutic modalities. Ann Periodontol 6:113–118CrossRef
29.
go back to reference Kolbe MF, Ribeiro FV, Luchesi VH, Casarin RC, Sallum EA, Nociti FH Jr et al (2014) Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immune inflammatory, and patient centered performance in a split-mouth randomized clinical trial. J Periodontol 85:e277–e286CrossRef Kolbe MF, Ribeiro FV, Luchesi VH, Casarin RC, Sallum EA, Nociti FH Jr et al (2014) Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immune inflammatory, and patient centered performance in a split-mouth randomized clinical trial. J Periodontol 85:e277–e286CrossRef
30.
go back to reference Singh M, Bains VK, Jhingran R, Srivastava R, Madan R, Maurya SC et al (2019) Prevalence of periodontal disease in type 2 diabetes mellitus patients: a cross-sectional study. Contemp Clin Dent 10:349–357PubMedPubMedCentral Singh M, Bains VK, Jhingran R, Srivastava R, Madan R, Maurya SC et al (2019) Prevalence of periodontal disease in type 2 diabetes mellitus patients: a cross-sectional study. Contemp Clin Dent 10:349–357PubMedPubMedCentral
Metadata
Title
Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser
Authors
Sunakshi Soi
Vivek Kumar Bains
Ruchi Srivastava
Rohit Madan
Publication date
01-08-2021
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 6/2021
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-021-03261-w

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